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Home My WebLink AboutBuilding Permit #145-2016 - 796 CHICKERING ROAD 8/3/2015 OF NO oT b 1 BUILDING PERMIT t6 TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION * _ Permit No#: � Date Received Eo SAC14 Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION LVQE�Vic, le:qint PROPERTY OWNER J e_ `r `b G� Ci N S Print 100 Year Structure yes o MAP ��PARCEL: ZONING DISTRICT: Historic District yes o Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family El Addition El Two or more family El Industrial ❑Alteration No. of units: [I Commercial oRepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other I flrSeptic ❑1Nell ,h �'Flootlplarn, Wetland, TI .� UV to ershedi�Dstrict a Water/Sewer6_- + DE CRIPTION OF WORK TO BEP RFORMED: d G S (4 r f 5 (fYl e S f N P Gk- flp4tificatio - Please Type or Pr' t arty OWNER: Name: �"r' �t' a C2 r Phone: Address: 9� �1 ��e n n I�C1 IV u Contractor N me: egn Ga�S (7JG JtCA 0Phone: Email: Sp le--S V P.e1y7 Co✓I 5 -rzc (an c , c pOl Address: r-n i k S awre / Supervisor's Construction License: �-5-0-7 6 C Exp. Date: Home Improvement License: , 0 ?J�3 Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST ASED ON$125.00 PER S.F. 4 Total Project Cost: $�` � 1 b U FEE: $ Check No.: I�� I Receipt No.: ` NOTE: Persons contracting with unregistered contractors do not have access to gua n and ,Q -- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanuing/Massage/Body Art ❑ Swiuuning Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennaaent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on 3) 1 Signature COMMENTS C c� cv a Wp �w'• � �D` 9 e_' vii ` HEALTH Reviewed on Signature I COMMENTS i Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes _a Planning Board Decision: Comments t "Conservation Decision: Comments ,T Water& Sewer Connection/signature Date Driveway Permit I DPW Town Engineer: Signature: Located 384 Osgood Street .•-s`� :E S'�-T t is".. 'F S .es: S h'}ag 4�as,r �•r:►;�..;-f �f.,�$,�'` t*e...w.v� DEPARd MENT� - e"l•,rnp�Du psier�onxsite? 40cated at 1-1 MaijStreeK ' - , ; • � ;. . ._ -- -- ��"�-=-+-3^�.-T ...§—iRi`we"z� t F•^47i ��v � k�+1�,. .fi fi*�f'i{T "•.•. z... - 41... +�.� ? Fire Departmentsi ,�ti ♦rt.ani..�Gt.sl.w: •.;� �y. +$+fi L„i�•.a� t�♦, ''� i Tr Vie:a �,� Ari �; � .t{3T*"� � ; {a'.�.� �'� s ..p CM I V I s a}_ i^- . ._ a. r . s :1r ?% 1 :, 2•'. f i: Y+' H Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) �I a cncQ I ® Notified for pickup Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits Building Permit Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks a, Building Permit Application 6 Certified Surveyed Plot Plan 4 Workers Comp Affidavit 4, Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products . OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Building Permit Application 4� Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014